| Entity Name: | FS TENANT POOL I TRUST |
| Jurisdiction: | FLORIDA |
| Filing Type: | Declaration of Trust |
| Status: | Inactive |
| Date Filed: | 09 Nov 2001 (23 years ago) |
| Date of dissolution: | 17 Jan 2025 (16 days ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 17 Jan 2025 (16 days ago) |
| Document Number: | D01000000027 |
| Address: | 400 CENTRE STREET, NEWTON, MA 02458 |
| Mail Address: | 400 CENTRE STREET, MA 02458 |
| Place of Formation: | MARYLAND |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1528001609 | 2006-06-14 | 2019-03-27 | 400 CENTRE ST, NEWTON, MA, 024582094, US | 8500 ROYAL PALM BLVD, CORAL SPRINGS, FL, 330655715, US | |||||||||||||||||||||||||||||
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| Phone | +1 617-796-8387 |
| Fax | 6177938375 |
| Phone | +1 954-752-9500 |
| Fax | 9547559559 |
Authorized person
| Name | KATHERINE E POTTER |
| Role | PRESIDENT & CHIEF EXECUTIVE OFFICER |
| Phone | 6177968387 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| License Number | AL4917 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 025413400 |
| State | FL |
| Name | Role |
|---|---|
| CORPORATION SERVICE COMPANY | Agent |
| Name | Date |
|---|---|
| Amendment | 2025-01-17 |
| Declaration of Trust | 2001-11-09 |
Date of last update: 31 Jan 2025
Sources: Florida Department of State
